Higher Education Emergency Relief Fund (HEERF) I, II and III Data Collection Form

Conducted by: OMB No. 1840-0850 Expires 12/31/2023

U.S. Department of Education

Higher Education Emergency Relief Fund (HEERF) I, II, & III Data Collection Form

DRAFT 9/27/21

This data collection form applies to the following HEERF categories authorized under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA), and the American Rescue Plan (ARP):

• Student Aid (CFDA 84.425E)

• Institutional Portion (CFDA 84.425F)

• Historically Black Colleges and Universities (CFDA 84.425J)

• American Indian Tribally Controlled Colleges and Universities (CFDA 84.425K)

• Minority Serving Institutions (CFDA 84.425L)

• Strengthening Institutions Program (CFDA 84.425M)

• Fund for the Improvement of Postsecondary Education (CFDA 84.425N)

• Proprietary Institutions Grant Funds for Students (CFDA 84.425Q)

The information collected on this form will be reviewed by U.S. Department of Education employees to ensure that HEERF funds are used in accordance with applicable requirements under the CARES Act, CRRSAA, and ARP and will be shared with the public to promote transparency regarding the allocation and uses of funds. Furthermore, the information collected will be analyzed to provide aggregate statistics on IHE use of Education Stabilization Fund (ESF) funds to address the impacts of the COVID-19 virus on students and institutions.

HEERF Reporting Form

Annual Reporting: This report should be completed based on all HEERF activities (HEERF I, II, and III) in the applicable reporting periods. Failure to meet the HEERF reporting requirements is a violation of the grantee’s certification and agreement and could lead to adverse action.

Reporting Schedule
Annual Report	Due Date	Applicable Reporting Period
First Annual Report	Early 2021	March 13, 2020—December 31, 2020
Second Annual Report	Early 2022	January 1, 2021—December 31, 2021
Third Annual Report	Early 2023	January 1, 2022—December 31, 2022
Fourth Annual Report	Early 2024	January 1, 2023—December 31, 2023
Fifth Annual Report	Early 2025	January 1, 2024—December 31, 2024

In order to meet HEERF program requirements, institutions need to provide complete answers to each question. However, for the second annual report covering January 1, 2021-December 31, 2021, institutions have the option of taking more time to submit answers to questions marked with an asterisk(*). Institutions can submit answers to questions marked with an asterisk in early 2022 as part of the second annual report (in alignment with the table above) OR in early 2023 as part of the third annual report. Starting with the third annual report, institutions need to provide answers to all questions including those marked with an asterisk per the reporting schedule in the table above.

1. Institutional Identifiers and Contact Information—

1. Institution Name ___<autofill from G5> ______

DUNS # ___<autofill from G5>_______

SAM # ___ <autofill>_______

2. Identify the OPEID(s) for this institution:

_______________________________________________________________________

2. For this annual report, please report on these HEERF grant PR/Award Numbers:

1. ___<autofill Award Number and Amount from G5>_____________________

2. ___<autofill Award Number and Amount from G5>_____________________

3. ____...____________________

2. Who is the lead contact for this annual report?

Name: ___<autofill> ______ (editable)

Title: ___<autofill> ______ (editable)

Phone: ___<autofill> ______(editable)

Email: ___<autofill> ______ (editable)

2. <Skip logic question-if all HEERF I, II, and III funds were expended in the current reporting period, no reporting is required for subsequent years> Did you expend all of your HEERF I, II, & III funds available prior to the end of the reporting period, making this your final annual report? ____(Y/N)¹

2. Reporting on institution websites:

1. HEERF quarterly reporting webpage URL: __________________________

2. Student Portion Reporting: Provide all active website URLs posted by your campus, or by the institution on behalf of your campus(es), as required by the May 6 notice in the Federal Register² for the student portion including any active URLs that provide archived information.

   1. _________________________________

   2. _________________________________

   3. _________________________________

   4. _________________________________

<option to add more, as needed>

3. Institutional Portion, (a)(1), (a)(2), and (a)(3) reporting: Provide all active website URLs posted by your campus, or by the institution on behalf of your campus(es), as required by the quarterly Higher Education Emergency Relief Fund (HEERF) Data Collection Form³ including any active URLs that provide archived information.

   1. ________________________________

   2. ________________________________

   3. ________________________________

<option to add more, as needed>

4. How has HEERF helped your institution and your students?

Statement	Scale Response
a.) My institution was at risk of closing due to pandemic-related factors and HEERF has enabled my institution to continue operating.	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable
b.) HEERF enabled my institution to continue offering planned programs (i.e., programs of study listed in our course catalog) that were at risk of discontinuation due to pandemic-related factors.	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable
c.) HEERF enabled my institution to keep student net prices similar to pre-pandemic levels (i.e., minimal increases to tuition and fees, minimal decreases to scholarships, etc.).	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable
d.) HEERF enabled my institution to keep students enrolled by providing them with electronic devices and Internet access.	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable
e.) HEERF enabled my institution to keep students enrolled who were at risk of dropping out due to pandemic-related factors by providing direct financial support to students.	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable
f.) HEERF enabled my institution to keep faculty, staff, employees, and contractors at full salary levels who were at risk of unemployment due to pandemic-related factors.	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable
g.) HEERF enabled my institution to purchase COVID tests, health screening, and the healthcare needed to help students and faculty.	5. Strongly disagree, 4. Disagree, 3. Neutral, 2. Agree, 1. Strongly agree 0. Not applicable

4. How did your institution determine which students received emergency financial aid grants to students and how much each student would receive? Please indicate if any of the following strategies were used at least once during the reporting period.

• Did you distribute the same amount to all students regardless of different circumstances? ______(Y/N). If no,

  • Did you ask students to apply for funds? (Y/N). If yes,

    • Did you use that application to determine the amount of a student’s emergency financial aid grant? ______(Y/N). If yes,

      • What needs did you prioritize to determine the amount of the student’s award?

        1. Food ___ (Y/N)

        2. Housing _____ (Y/N)

        3. Course materials (non-technology) ____ (Y/N)

        4. Technology _____ (Y/N)

        5. Health care ____ (Y/N)

        6. Child care ______(Y/N)

        7. Transportation____(Y/N)

        8. Lost income (e.g., Loss of Employment/Reduced Income) ___(Y/N)

        9. Other (Y/N). If yes, please specify___________

      • Did your application require students to submit supporting documentation of their needs or difficulty meeting expenses? (Y/N)

  • Did you use any institutional administrative data (pre-existing data that did not come from a HEERF-specific application form) in determining the amount of funds awarded to students? ______(Y/N). If yes,

    • Which of these student factors did you prioritize in the grant determination process? (Mark all that apply)

      • Enrollment intensity (i.e., full-time/part-time status, number of credits the student is taking, etc.) ______(Y/N).

      • Location (i.e., branch campus) ______(Y/N).

      • Pell Grant eligibility ______(Y/N).

      • FAFSA data elements ______(Y/N). If yes,

        1. Which FAFSA data elements did you use?

           1. FAFSA Family Income ______(Y/N).

           2. Estimated Family Contribution ______(Y/N).

           3. independent/dependent status ______(Y/N).

      • On-campus/distance education status ______(Y/N).

      • On-campus/off-campus living arrangements ______(Y/N).

      • Academic level ______(Y/N).

      • Other (Y/N). If yes, please specify_____________________________

  • Did your institution use a specific methodology to calculate award amounts that is captured in a flowchart, set of equations, a formula, or other documentation? ___(Y/N). If yes,

    • (upload PDF/MS Word document)

or

• Provide any active URLs ___________________

<option to add more, as needed>

4. How did your institution distribute the emergency financial aid grants to students?

1. Checks _____ (Y/N).

2. Electronic funds transfer /Direct deposit _____(Y/N).

3. Debit cards _____ (Y/N).

4. Payment apps _____ (Y/N).

5. Other (Y/N). If yes, please specify _______________________

4. Did your institution provide any instructions, directions, or guidance to students (e.g., FAQs) about the emergency financial aid grants upon disbursement? _____(Y/N). If yes,

   1. (upload PDF/MS Word document instructions, directions, or guidance)

or

2. Provide any active URLs with instructions, directions, or guidance on how to use the grants _______________________________________

<option to add more, as needed>

4. What proportion of students received emergency grants and how much did students receive in emergency grants by fund type and student type?

Note: In early 2022, for the second annual report covering January 1, 2021-December 31, 2021, institutions have the option of taking more time to submit answers to questions marked with an asterisk(*). Institutions can submit answers to questions marked with an asterisk in early 2022 as part of the second annual report (in alignment with the reporting schedule at the beginning of this data collection form) OR in early 2023 along with reporting the third annual report.

1. Complete the following table.

Emergency Financial Aid Grants Awarded to Students (direct grants and amounts reimbursed)
		All students	Undergraduates4				Graduates
			Full-time students5		Part-time students		Full-time students	Part-time students
			Pell grant recipient6	Non-Pell grant recipient7	Pell grant recipient	Non-Pell grant recipient
Number of Students	How many students were enrolled? (unduplicated count for the reporting period)	<autofill: sum of #s in row>
Number of HEERF Student Recipients – Emergency Grants to Students (unduplicated)	How many students received HEERF emergency financial aid grants? (unduplicated across all HEERF sections)	<autofill: sum of #s in row>
HEERF Amount Disbursed (Section 18004(a)(1) Student Aid Portion)	What was the amount disbursed directly to students as Emergency Financial Aid Grants?	<autofill: sum of #s in row>
	What was the amount used to cover a student’s outstanding account balance for costs such as debt forgiveness, room, board, tuition, or fees (upon receiving affirmative written consent from students to do so)? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
HEERF Amount Disbursed (18004(a)(1) Institutional Portion)	What was the amount disbursed directly to students as Emergency Financial Aid Grants?	<autofill: sum of #s in row>
	What was the amount used to cover a student’s outstanding account balance for costs such as debt forgiveness, room, board, tuition, or fees ? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
<SKIP LOGIC for those who did not receive these funds> HEERF Amount Disbursed (Section 18004 (a)(2))- HBCUs, TCCUs, MSIs, SIP)	What was the amount disbursed directly to students as Emergency Financial Aid Grants? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
	What was the amount used to cover a student’s outstanding account balance for costs such as debt forgiveness, room, board, tuition, or fees ? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
<SKIP LOGIC for those who did not receive these funds> HEERF Amount Disbursed (Section 18004 (a)(3))- FIPSE & SAIHE	What was the amount disbursed directly to students as Emergency Financial Aid Grants? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
	What was the amount used to cover a student’s outstanding account balance for costs such as debt forgiveness, room, board, tuition, or fees ? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
<SKIP LOGIC for those who did not receive these funds> HEERF Amount Disbursed (Section 18004 (a)(4))- Proprietary Institutions Grant Funds for Students	What was the amount disbursed directly to students as Emergency Financial Aid Grants? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
	What was the amount used to cover a student’s outstanding account balance for costs such as debt forgiveness, room, board, tuition, or fees (upon receiving affirmative written consent from students to do so)? If funds were not used for this purpose, report $0.	<autofill: sum of #s in row>
Minimum and maximum awards	Minimum (non-zero amount) combined (combined across HEERF funds) amount awarded to any one student who received any HEERF funds and by student recipients	<autofill: min of #s in row>
	Maximum combined (combined across HEERF funds) amount awarded to any one student who received any HEERF funds and by student recipients	<autofill: max of #s in row>
HEERF Amount of Grants Disbursed	What was the amount of grants disbursed to students through all HEERF funds?	<autofill: calculated from #s above>	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >
Average HEERF Amount Awarded	Among students who received HEERF emergency financial aid grants, what was the average award amount per student?	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >	<autofill: calculated from #s above >

2. *Among the students enrolled in your institution, how many were NOT title IV eligible⁸ throughout their enrollment during the reporting period? ____

   1. *The percentage of students enrolled in your institution who were NOT title IV eligible throughout their enrollment during the reporting period is____. <autofill answer from 8b divided by the “Number of Eligible Students” value from 8a>

2. *Among students who received emergency grants, how many were not title IV eligible throughout their enrollment during the reporting period? ____

   1. *The percentage of students who received emergency grants who were not title IV eligible throughout their enrollment during the reporting period is____. <autofill answer from 8c divided by the total “Number of HEERF Student Recipients” value from 8a>

2. *What proportion of students by IPEDS race/ethnicity categories received emergency grants and how much grant aid did the students receive?

Race/Ethnicity	Enrolled student count (unduplicated)	Number of students who received at least one Emergency Financial Aid Grant (unduplicated)	What was the total amount of Emergency Financial Aid Grants disbursed to students through all HEERF funds?	Average HEERF Amount Awarded
American Indian or Alaska Native				<autofill>
Asian				<autofill>
Black or African American				<autofill>
Hispanic				<autofill>
Native Hawaiian or Other Pacific Islander				<autofill>
White				<autofill>
Two or more races				<autofill>
Race/ethnicity unknown				<autofill>
Nonresident alien				<autofill>
Students not categorized in IPEDS				<autofill>

5. *What proportion of students by IPEDS gender categories received emergency grants and how much grant aid did the students receive?

Gender	Enrolled student count (unduplicated)	Number of students who received at least one Emergency Financial Aid Grant (unduplicated)	What was the total amount of grants disbursed to students through all HEERF funds?	Average HEERF Amount Awarded
Men				<autofill>
Women				<autofill>
Students not categorized in IPEDS				<autofill>

5. *What proportion of students by IPEDS age categories received emergency grants and how much grant aid did the students receive?

Age9	Enrolled student count (unduplicated)	Number of students who received at least one Emergency Financial Aid Grant (unduplicated)	What was the total amount of grants disbursed to students through all HEERF funds?	Average HEERF Amount Awarded
Ages 25 and older				<autofill>
Ages 24 and younger				<autofill>
Age not available in administrative records (e.g., IPEDS, FAFSA, etc.)				<autofill>

4. Institutional expenditures

   1. Has your institution designated HEERF program funds for a specific purpose or budget objective in future calendar years (for example, operation and maintenance of plant, academic programs, residential programs, future institutional aid)? __ (Y/N)

      1. If no, are HEERF program funds being held in the institution’s general fund for use as needed? __ (Y/N)

1.1. If no HEERF program funds are being held in the institution’s general fund, explain your institution’s approach: _______________

(1,000 characters maximum)

2. If yes, provide the amount designated for a specific purpose or budget objective by calendar year and HEERF program fund:

HEERF program fund	Calendar year 2022	Calendar year 2023	Calendar year 2024
(a)(1) Institutional Portion
(a)(2)- HBCUs, TCCUs, MSIs, SIP
a(3)- FIPSE and SAIHE

2. Provide the total amount of HEERF funds expended during the reporting period on each of the following categories:

Category	Amount in (a)(1) institutional dollars	Amount in (a)(2) dollars, if applicable	Amount in (a)(3) dollars, if applicable	Explanatory Notes
Providing additional emergency financial aid grants to students.10	<autofill from Q8>	<autofill from Q8>	<autofill from Q8>
Covering student outstanding account balances for costs such as debt forgiveness, room, board, tuition, or fees (upon receiving affirmative written consent from students to do so).	<autofill from Q8>	<autofill from Q8>	<autofill from Q8>
Indirect cost recovery/facilities and administrative costs charged on the grants.
Covering the cost of providing additional technology hardware to students, such as laptops or tablets, or covering the added cost of technology fees.
Providing or subsidizing the costs of high-speed internet to students or faculty to transition to an online environment.
Subsidizing off-campus housing costs due to dormitory closures or decisions to limit housing to one student per room; subsidizing housing costs to reduce housing density; paying for hotels or other off-campus housing for students who need to be isolated; paying travel expenses for students who need to leave campus early due to coronavirus infections or campus interruptions.
Subsidizing food service to reduce density in eating facilities, to provide pre-packaged meals, or to add hours to food service operations to accommodate social distancing.
Costs related to operating additional class sections to enable social distancing, such as those for hiring more instructors and increasing campus hours of operations.
Campus safety and operations.11
Purchasing, leasing, or renting additional instructional equipment and supplies (such as laboratory equipment or computers) to reduce the number of students sharing equipment or supplies during a single class period and to provide time for disinfection between uses.
Purchasing faculty and staff training in online instruction; or paying additional funds to staff who are providing training in addition to their regular job responsibilities.
Purchasing, leasing, or renting additional equipment or software to enable distance learning, or upgrading campus wi-fi access or extending open networks to parking lots or public spaces, etc.
Implementing evidence-based practices to monitor and suppress coronavirus in accordance with public health guidelines.12
Conducting direct outreach to financial aid applicants about the opportunity to receive a financial aid adjustment due to the recent unemployment of a family member or independent student, or other circumstances, described in section 479A of the Higher Education Act of 1965.
Replacing lost revenue from all sources. 13
Other Uses of (a)(1) Institutional Portion funds.14
Other uses of (a)(2) or (a)(3) funds, if applicable.15
Annual Expenditures for each Program
Total of Annual Expenditures

<SKIP LOGIC for those who reported nonzero amounts for replacing lost revenue>

3. Estimate how much of the lost revenue reported above came from each of the following sources:

Source of Lost Revenue	Estimated Amount
Academic sources
Unpaid student accounts receivable or other student account debts (including tuition, fees, and institutional charges)
Room and board
Enrollment declines, including reduced tuition, fees, and institutional charges
Supported research
Summer terms and camps
Auxiliary services sources
Cancelled ancillary events
Disruption of food service
Dormitory services
Childcare services
Use of facilities or venues, including external events such as weddings, receptions, or conferences (other than facilities associated with sectarian instruction or religious worship)
Bookstore revenue
Parking revenue
Lease revenue
Royalties
Other operating revenue
Total (a)(1) funds	<autofill from Q9b>
Total (a)(2) funds	<autofill from Q9b>
Total (a)(3) funds	<autofill from Q9b>
TOTAL HEERF	<autofill from Q9b>16

<SKIP LOGIC for those who reported other operating revenue in 9c>

4. Briefly describe the “other operating revenue” reported above:_ ______________________ (1,000 characters maximum]

4. Provide the unduplicated count of students who were enrolled at least once as a degree/certificate seeking student within the reporting period and their enrollment status at the end reporting period. The three statuses (completed, withdrawn, and still enrolled) need to add up to the total number of students enrolled.

   1. Complete the following table for the applicable reporting period.

Note: In early 2022, for the second annual report covering January 1, 2021-December 31, 2021, institutions have the option of taking more time to submit answers to questions marked with an asterisk(*). Institutions can submit answers to questions marked with an asterisk in early 2022 as part of the second annual report (in alignment with the reporting schedule at the beginning of this data collection form) OR in early 2023 along with the third annual report. For example, the enrollment statuses for academic level categories (undergraduate and graduate) need to be submitted for each applicable reporting period in alignment with the reporting schedule at the beginning of this data collection form. However, in the early 2022 data collection process, the race/ethnicity, gender, and age categories can be submitted later along with the third annual report in early 2023.

Enrollment status for all degree/certificate seeking students
		Number of degree/certificate seeking students	Number of degree/certificate seeking students who completed a program at your institution	Number of degree/certificate seeking students who did not complete but were still enrolled at your institution (i.e., last enrollment record at the end of the reporting period is not a withdraw record)	Number of degree/certificate seeking students who did not complete and withdrew from your institution (i.e., no completion record and the last enrollment record at the end of the reporting period is a withdraw record)
Academic level17	Undergraduate students
	Graduate students
*Pell grant status18 (undergraduates only)	Pell grant recipients
	Non-Pell grant recipients
*Enrollment intensity19	Part-time
	Full-time
*Race/ethnicity	American Indian or Alaska Native
	Asian
	Black or African American
	Hispanic or Latino
	Native Hawaiian or Other Pacific Islander
	White
	Two or more races
	Race/ethnicity unknown
	Nonresident alien
	Students not categorized in IPEDS
*Gender	Women
	Men
	Students not categorized in IPEDS
*Age	Ages 25 and older
	Ages 24 and younger
	Age not available in administrative records (e.g., IPEDS, FAFSA, etc.)

2. Complete the following table. This table does not have to be updated on an annual basis. Institutions should submit responses in the early 2022 data collection process. However, if institutions need more time, they can submit responses in the early 2023 data collection process.

*Comparison for calendar year 2020: Enrollment status for all degree/certificate seeking students
		Number of degree/certificate seeking students	Number of degree/certificate seeking students who completed a program at your institution	Number of degree/certificate seeking students who did not complete but were still enrolled at your institution (i.e., last enrollment record at the end of the calendar year is not a withdraw record)	Number of degree/certificate seeking students who did not complete and withdrew from your institution (i.e., no completion record and the last enrollment record at the end of the calendar year is a withdraw record)
*Academic level20	Undergraduate students
	Graduate students
*Pell grant status21 (undergraduates only)	Pell grant recipients
	Non-Pell grant recipients
*Enrollment intensity22	Part-time
	Full-time
*Race/ethnicity	American Indian or Alaska Native
	Asian
	Black or African American
	Hispanic or Latino
	Native Hawaiian or Other Pacific Islander
	White
	Two or more races
	Race/ethnicity unknown
	Nonresident alien
	Students not categorized in IPEDS
*Gender	Women
	Men
	Students not categorized in IPEDS
*Age	Ages 25 and older
	Ages 24 and younger
	Age not available in administrative records (e.g., IPEDS, FAFSA, etc.)

3. Complete the following table. This table does not have to be updated on an annual basis. Institutions should submit responses in the early 2022 data collection process. However, if institutions need more time, they can submit responses in the early 2023 data collection process.

*Comparison for all 2019 Enrollment status for degree/certificate seeking students
		Number of degree/certificate seeking students enrolled during the calendar year	Number of degree/certificate seeking who completed a program at your institution by the end of the calendar year	Number of degree/certificate seeking students that were still enrolled at your institution (i.e., last enrollment record at the end of the calendar year is not a withdraw record)	Number of degree/certificate seeking students who did not complete and withdrew from your institution (i.e., no completion record and the last enrollment record at the end of the calendar year is a withdraw record)
*Academic level23	Undergraduate students
	Graduate students
*Pell grant status24 (undergraduates only)	Pell grant recipients
	Non-Pell grant recipients
*Enrollment intensity25	Part-time
	Full-time
*Race/ethnicity	American Indian or Alaska Native
	Asian
	Black or African American
	Hispanic or Latino
	Native Hawaiian or Other Pacific Islander
	White
	Two or more races
	Race/ethnicity unknown
	Nonresident alien
	Students not categorized in IPEDS
*Gender	Women
	Men
	Students not categorized in IPEDS
*Age	Ages 25 and older
	Ages 24 and younger
	Age not available in administrative records (e.g., IPEDS, FAFSA, etc.)

4. Provide the number of full-time equivalent (FTE) positions as of the listed reporting dates by IPEDS categories. (The number of FTE positions includes all staff regardless of whether the position is funded by Federal, State, local, or other funds—including instructional and non-instructional staff and contractors—and equals the sum of the number of full-time positions plus the full-time equivalent of the number of part-time positions).

	Full-time equivalent (FTE) positions as of November 1, 2018	Full-time equivalent (FTE) positions as of November 1, 2019	Full-time equivalent (FTE) positions as of November 1, 2020	Full-time equivalent (FTE) positions as of November 1, 2021
Instructional Staff26
Non-Instructional Staff

4. Did your institution receive approval from your primary accreditor to offer distance education after the start of the national emergency?

1. Did your institution receive temporary approval from your primary accreditor to offer distance education? (Y/N)

2. Did your institution receive permanent approval from your primary accreditor to offer distance education? (Y/N)

3. Provide the name of your institution’s primary accreditor that provided temporary and/or permanent approval: _______________

Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1840-0850. Public reporting burden for this collection of information is estimated to average 40 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Under the PRA, participants are required to respond to this collection to obtain or retain a benefit. If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, please contact Brian Fu, US. Department of Education, 400 Maryland Avenue, SW, Washington, DC 20202.

1 Institutions that expended all of their HEERF funds in calendar year 2021 may need to finalize their calendar year 2021 reporting in early 2023 if they choose to delay reporting on the questions labeled with an asterisk until the early 2023 reporting timeframe.

2 Seehttps://ifap.ed.gov/electronic-announcements/050620HigherEdEmergencyReliefFundRptg.

3 See https://www2.ed.gov/about/offices/list/ope/heerfreporting.html.

4 For students in both undergraduate and graduate categories, classify as a graduate student.

5 For students who had multiple enrollment intensities, classify as full-time.

6 Designate the student as a Pell grant recipient if the student was a Pell grant recipient at any time within the applicable reporting period.

7 Includes non-FAFSA filers.

8 Based on guidance updated on May 11, 2021 (see https://www2.ed.gov/about/offices/list/ope/arpfaq.pdf), students are no longer required to be eligible for Title IV student financial aid in order to receive HEERF grants to students. Title IV eligibility for this question is based on the number of students for whom the institution has received an Institutional Student Information Record (ISIR) plus the number of students who completed any alternative form developed by the institution. In reporting these data, students should be classified as Title IV eligible if they were determined to be Title IV eligible at any point during the reporting period.

9 Institutions should follow IPEDS Fall enrollment guidelines for when to capture a student’s age. For example, institutions operating on a traditional academic year calendar (semester, trimester, quarter, or 4-1-4) report Fall enrollment as of the institution's official fall reporting date or October 15. Institutions operating on a calendar that differs by program or that enrolls students on a continuous basis (referred to as program reporters) report Fall enrollment as students enrolled any time during the period August 1 and October 31.

10 To support expenses related to the disruption of campus operations due to coronavirus consistent with applicable law. This includes eligible expenses under a student’s cost of attendance under CARES Act Section 18004(c), or any component of a student’s cost of attendance or for emergency costs that arise due to coronavirus, such as tuition, food, housing, health care (including mental health care), or childcare, per Section 314(c) of the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSAA), and Section 2003 of the American Rescue Plan Act of 2021 (ARP).

11 Including costs or expenses related to the disinfecting and cleaning of dorms and other campus facilities, purchases of personal protective equipment (PPE), purchases of cleaning supplies, adding personnel to increase the frequency of cleaning, the reconfiguration of facilities to promote social distancing, etc.

12 Including funding to cover the cost of vaccine distribution.

13 Please see the Department’s HEERF Lost Revenue FAQs (March 19, 2021) for more information regarding what may be appropriately included in an estimate of lost revenue.

14 Please post additional documentation as appropriate and briefly explain in the “Explanatory Notes” section. Please note that funds for (a)(1) Institutional Portion may be used to defray expenses associated with coronavirus (including lost revenue, reimbursement for expenses already incurred, technology costs associated with a transition to distance education, faculty and staff trainings, and payroll).

15 Please post additional documentation as appropriate and briefly explain in the “Explanatory Notes” section.

Please note that funds for (a)(2) and (a)(3) may be used to defray expenses associated with coronavirus (including lost revenue, reimbursement for expenses already incurred, technology costs associated with a transition to distance education, faculty and staff trainings, and payroll).

16 Estimated amounts need to sum to amounts reported in 9b

17 For students in both undergraduate and graduate categories, classify as a graduate student.

18 Designate the student as a Pell grant recipient if the student was a Pell grant recipient at any time within the applicable reporting period.

19 For students who had multiple enrollment intensities, classify as full-time.

20 For students in both undergraduate and graduate categories, classify as a graduate student.

21 Designate the student as a Pell grant recipient if the student was a Pell grant recipient at any time within the applicable reporting period.

22 For students who had multiple enrollment intensities, classify as full-time.

23 For students in both undergraduate and graduate categories, classify as a graduate student.

24 Designate the student as a Pell grant recipient if the student was a Pell grant recipient at any time within the applicable reporting period.

25 For students who had multiple enrollment intensities, classify as full-time.

26 An occupational category that is comprised of staff who are either: 1) Primarily Instruction or 2) Instruction combined with research and/or public service. The intent of the Instructional Staff category is to include all individuals whose primary occupation includes instruction at the institution.

20